Category Archives: Affordable Care Act (ACA)

Feb 24 2014
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Generation Y’s Role in Making the Marketplaces Work and Advancing a Culture of Health

Sue No, RN, BSN, is a fellow in the Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at the University of New Mexico (2013-2017). She is working toward her PhD in nursing with a concentration in health policy. This post is part of the “Health Care in 2014” series.

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Every New Year brings New Year’s resolutions. It is a time for reflection on years past and to develop actionable changes needed for a hopeful and productive new year. Clearly 2014 is no exception. With the New Year already in full swing, I encourage people—yes, this also includes you, Generation Y—to enroll in a health insurance plan and take advantage of the Affordable Care Act’s (ACA) current and new coverage opportunities in an effort to advance our nation’s culture of health.

You might be asking yourself a few questions such as: Who is Generation Y and why are they important? I am happy to provide answers.

The largest generation, Generation Y, or Millennials, consists of young adults born between 1977 and 1994. This important demographic is key to obtaining a sustainable health care exchange system with affordable insurance plans. Healthy Millennials must enroll in the marketplace to offset the high costs acquired by the disproportionate number of Americans with high medical costs. Unfortunately, only a small number of young adults have participated in the health care exchange since open enrollment. This isn’t surprising. 

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Feb 21 2014
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Quotable Quotes About Nursing, February 2014

This is part of the February 2014 issue of Sharing Nursing’s Knowledge.

“As an ADN-prepared nurse returning to school, I have been confronted with the formidable gap between the current reality of professional nursing and the push to elevate the level and scope of practice in the face of a projected nursing shortage. I have no doubt that higher levels of education, certification, and experience have the potential to create better nurses and in turn safer environments for our patients, but I do have to question whether the infrastructure necessary to support these changes is in place.”
--Eric Deane, RN, Charlottesville, Va., Thoughts on Entry to Practice, Nurse.com, February 10, 2014

“As medical professionals we are recognizing that on a national level, advanced practice nurses [APNs] are part of the solution to the health care access crisis. The only way that patients are going to get the care they need is if all parts of the medical team, including APNs, midwives, physician’s assistants, physicians, and others, come together as partners. It’s not that nurse practitioners are going to replace any other clinicians. That’s not our goal. But advanced practice nurses are extraordinarily well prepared to provide primary care. They are trained in managing multiple types of health problems and in promoting a healthy lifestyle. With the current challenges in patient care, I can only see the role of the nurse practitioner increasing.”
--Ivy Alexander, PhD, APRN, FAAN, clinical professor and director of advanced practice programs, University of Connecticut School of Nursing, An Expanding Role for Nurse Practitioners, Medical Xpress, February 5, 2014

“More needs to be done to help spread awareness [about the Affordable Care Act]. This is one of the things nurses do best. They educate.”
--Mary Wakefield, PhD, RN, FAAN, administrator, Health Resources & Services Administration, Nurses Step Out to Help with ACA Enrollment, Nursezone.com, January 31, 2014

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Feb 14 2014
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Affordable Care Act Marketplaces Can Contribute to Health System Transformation!

Jay Himmelstein, MD, MPH, is a professor of family medicine and community health and chief health policy strategist at the Center for Health Policy and Research at the University of Massachusetts Medical School (UMMS). He serves as a senior advisor to the UMMS Office of Policy and Technology, and is a senior Fellow in health policy at NORC, University of Chicago. Himmelstein is an alumnus of the Robert Wood Johnson Foundation Health Policy Fellows program, where he worked on the health staff of Senator Edward Kennedy. This post is part of the “Health Care in 2014” series.

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The nation's attention has focused in recent months on the politics and challenges related to the roll-out of state and federal health insurance marketplaces created by the Affordable Care Act (ACA). Despite website technical woes, significant numbers of Americans have already gained access to affordable insurance plans through the marketplaces and other provisions of the ACA, and it appears likely that the ‘marketplace’ concept will be successful over time in connecting consumers to health insurance and significantly decreasing the ranks of uninsured.

The better functioning marketplaces currently allow consumers to: 1) determine eligibility for subsidized health insurance, 2) use basic online shopping tools to compare and purchase health insurance plans based on four different "metallic tiers" (i.e., the platinum, gold, silver, and bronze tiers), and 3) make side-to-side comparisons between these plans on features such as deductibles, out-of-pocket cost limits, and number and proximity of doctors and hospitals. A few marketplaces also offer information about plan quality, the ability to search for health care providers and hospitals associated with specific plans, and rudimentary ‘cost calculators’ which estimate the total cost of plans inclusive of premiums, deductibles, and out-of-pocket costs.

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Jan 27 2014
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A Year of Dramatic Increase in Insurance Coverage

Michael Geruso, PhD, is a Robert Wood Johnson Foundation Scholar in Health Policy Research at Harvard University and an assistant professor of economics at the University of Texas at Austin. This post is part of the “Health Care in 2014” series.

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2014 marks the start of coverage for those who are newly insured via the health insurance exchanges. In general, healthy behaviors and lifestyle are probably the most important inputs to health, especially for those of us free of serious chronic conditions. But for those of us who are sick, quality health care and access to drugs is crucial for health and happiness. We will soon know to what extent the health insurance exchanges have overcome their implementation problems and have connected previously uninsured Americans to health care.
 
When markets for health insurance work efficiently, they can deliver access to crucial health services to those who need and want them most. Unfortunately, free, unregulated markets for health insurance rarely function efficiently. The market failures in health care have long been noted by economists, most famously by Nobel Prize winner Kenneth Arrow, MA, PhD. In my view, one the most important changes that the Affordable Care Act (ACA) brings with it is an attempt to address and correct market failures via the exchanges.

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Jan 16 2014
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Human Capital News Roundup: Racism and aging, the economics of obesity, a culture of fear for health care navigators, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Racism may accelerate aging in Black males, according to a study led by David Chae, ScD, MA, Forbes magazine reports. The study found advanced cellular aging in Black men who reported facing more racial discrimination and who had internalized anti-Black bias, according to the Black-White Implicit Association Test. Chae is an RWJF Health & Society Scholars alumnus. His research was also covered by: CBS News, The Baltimore Sun, The Atlanta Black Star, and The Huffington Post, among other outlets.

In an opinion piece for CNN, RWJF Executive Nurse Fellows alumna Cynda Hylton Rushton, PhD, RN, FAAN, discusses the ethical issues involved with end-of-life decisions. Rushton specifically addresses the impact of such situations on medical personnel who are providing treatment that may not be welcomed by patients or their family members.

Bloomberg Businessweek covers a National Bureau of Economics Research Reporter article by John Cawley, PhD, in which he discusses the economics of obesity. Cawley, an RWJF Scholars in Health Policy Research alumnus and member of the program’s National Advisory Committee, addresses health care spending on obesity, the effectiveness of weight-loss products, misuse of body-mass index, and more.

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Jan 9 2014
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Human Capital News Roundup: Demand for minority physicians, ADHD treatment, anxiety and strokes, and more

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Newly insured patients need time to adjust to not using emergency care as a primary medical service, Sara Rosenbaum, JD, recipient of an RWJF Investigator Award in Health Policy Research, told the New York Times. A study co-authored by Amy Finkelstein, PhD, MPhil, also a recipient of an RWJF Investigator Award, found that newly insured Medicaid recipients in Oregon went to the emergency room (ER) more often than people without insurance. The finding raises doubts about whether expanded insurance coverage will help control ER costs, at least in the short term. This story was also covered by NPR, NBC News, and CBS News.

Doctors who are Black, Hispanic, and Asian provide the most care to minority patients, and demand for their services may increase as the Affordable Care Act provides health insurance coverage to those who are currently without it, Bloomberg News reports. The story is based on a study co-authored by Steffie Woolhandler, MD, MPH, an RWJF Health Policy Fellows alumna. It was also covered by WBUR in Boston and The Charlotte Post.

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Jan 3 2014
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RWJF Clinical Scholars Podcast: Health Insurance and Employment

As many as 900,000 people across the country may leave their jobs now that the Affordable Care Act provides health insurance alternatives, according to Craig Garthwaite, PhD. In an interview with Robert Wood Johnson Foundation Clinical Scholar Chileshe Nkonde-Price, MD, Garthwaite uses an analysis of the Tennessee Public Health Insurance Program to explain why a significant number of American workers may not feel the need to stay with their current employers as subsidized health insurance becomes available through health insurance exchanges.

Garthwaite is assistant professor of management and strategy at the Northwestern University, Kellogg School of Management. The interview is part of a series of RWJF Clinical Scholars Health Policy Podcasts, co-produced with Penn’s Leonard Davis Institute of Health Economics.

The video is republished with permission from the Leonard Davis Institute.

Dec 30 2013
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YOUR Favorite Blog Posts of 2013 – Part One

The Robert Wood Johnson Foundation (RWJF) Human Capital Blog published nearly 400 posts in 2013. Which were your favorites? Today and tomorrow, as the year comes to an end, we’re taking another look at the posts published on this Blog in 2013 that attracted the most traffic.

A Closer, More Dispassionate Look at Obesity  RWJF Scholar in Health Policy Research alumna Abigail Saguy, PhD, discusses how fatness went from being considered a fashion problem to a social problem, a medical problem, and finally the public health crisis we see it as today. She says social perceptions of weight have affected medical interpretations, and shares her concern that some efforts to promote healthy lifestyles will exacerbate weight-based discrimination. Saguy’s interview was also the post most-shared on social media this year, generating more than 2,200 “likes” on Facebook.

A Chief Nursing Officer Who Does Not Have a BSN-Only Hiring Policy in Place  In a blog that is both personal and provocative, RWJF Executive Nurse Fellow alumnus Jerry Mansfield, PhD, RN, shares his journey to become a nurse, the setbacks he overcame, and how he has fulfilled his commitment to lifelong learning. He also addresses how he reconciled his support for the Institute of Medicine’s future of nursing education recommendations with the steps he had to take to meet demand for nurses at his institution. Mansfield is chief nursing officer at University Hospital and Richard M. Ross Heart Hospital, and a clinical professor at Ohio State University College of Nursing.

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Dec 26 2013
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Reshaping Today’s Bedside Care Team to Meet Tomorrow’s Challenges

The traditional bedside care team must evolve over the next five years in response to significant changes facing the U.S. health care system, according to the American Hospital Association (AHA), which recently convened a roundtable devoted to the issue.

“Reconfiguring the Bedside Care Team of the Future,” a white paper summarizing the discussion, points to several factors driving changes, including 25 million new patients entering the system as a result of the Affordable Care Act, an aging and increasingly diverse population, and more patients experiencing multiple conditions and acute episodes.

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Dec 10 2013
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Quotable Quotes About Nursing, December 2013

This is part of the December 2013 issue of Sharing Nursing's Knowledge.

“Nurse practitioners, health aides, pharmacists, dietitians, psychologists and others already care for patients in numerous ways, and their roles should expand in the future. The rise of nonphysician providers will enable more team care. Skilled health aides will monitor patients at home and alert a doctor if certain medical parameters decline. Nurses will provide wound care to diabetic patients, adjust medications like blood thinners and provide the initial management of chemotherapy side effects for cancer patients. ... Policy changes will be necessary to reach the full potential of team care. That means expanding the scope of practice laws for nurse practitioners and pharmacists to allow them to provide comprehensive primary care ... Most important, we need to change medical school curriculum to provide training in team care to take full advantage of the capabilities of nonphysicians in caring for patients.”
-- Scott Gottlieb, MD, American Enterprise Institute, and Ezekiel J. Emanuel, MD, PhD, University of Pennsylvania, No, There Won’t Be a Doctor Shortage, New York Times, December 4, 2013.

“Let me put it this way, we have over 1,200 pre-nursing students. I can only take about 108 a year. In the fall, we had over 600 applicants for 44 positions. Realistically, we are turning away people with 3.6 and 3.7 GPAs. And I think that story is playing out on CSU campuses everywhere.”
-- Dwight Sweeney, PhD, California State University, San Bernardino, Nursing Students Being Turned Away Amid Faculty Shortage in Cal State System, Los Angeles Daily News, December 1, 2013

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